Triton Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

60387 Issued in CA

Legal business name

TRITON DENTAL, LLC

Doing business as

Yosemite Dental Care

Practice address

49722 Road 426
Suite 104
Oakhurst, CA 93644-9047

Phone

(559) 683-4662

NPI assigned

Mar 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Timothy Michael Wieg, D.D.S.

Title

Clinical Director

Phone

(909) 269-1277

Specialties & licenses 1

Addresses

Other names 1

• Yosemite Dental Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1134660913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953380219",
            "telephone_number": "559-683-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49722 ROAD 426",
            "address_2": "SUITE 104",
            "city": "OAKHURST",
            "state": "CA",
            "postal_code": "936449047",
            "telephone_number": "559-683-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRITON DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "WIEG",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "909-269-1277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "60387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yosemite Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Oakhurst, CA
• Providers in Oakhurst, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.